Mistie

I know a lot of people are scared about/unsure about the first doctors appointment, so I thought I would share mine. Everyone is different, of course, and I know my surgeon's office did a lot, but here goes!

My appointment was at 8:15 AM. I checked in at 7:30ish, and was called back by 7:45.

I weighed (shoes on for first appointment *ahem* - the nurse laughed at me lol) and they checked my height.

I was put in a room, and within 5 minutes the nurse was back along with the Bariatric Nurse. They spent the next 45 minutes asking medical questions, getting history, etc. They also took photos (close up from the front, full body, and front the side) and did body measurements. They of course also checked my BP and temp.

After finishing, I waited about 15 minutes, and then the surgeon came in. She reviewed my history with me, checked my heart and lungs, and we discussed my weight history briefly. She also discussed my current weight and that I would need to lose just a little before surgery, but that the nutritionist would discuss the exact number with me. The visit with the surgeon, of course, was brief. But it was enough for me to know I *really* like her.

Probably about 5 minutes after the surgeon left, the nutritionist came in. We discussed the exact amount of weight I need to lose before surgery (~30 pounds), my goal weight, what my diet needs to look like now (~60-80g of Protein, less than 200g of carbs, less than 50g of fat, and approximately 1600 calories per day). She gave me a handout on high Protein foods, some tips for changing eating habits, etc. She also gave me a handout on daily Vitamin recommendations post-op, a pre-op nutrition plan, and samples (they use 'New Direction'). The pre-op diet is different from most. I start 4-6 weeks before surgery.

*Breakfast: Meal Replacement or shake equal to 200 calories

*Snack: fruit or low-fat yogurt equal to 200 calories (optional)

*Lunch: Meal Replacement or shake equal to 200 calories

*Dinner: Ready to eat meal (ie. Healthy Choice, Lean Cuisine, etc.) - around 400 calories. If it is not that many calories - add some veggies to get there. Since I'm on blood thinners and cannot eat a side salad, she suggested a baked or lean meat, Beans, green Beans, or even 1/2 a sweet potato.

*Snack: Meal replacement or shake equal to 200 calories (optional)

--64 ounces of Water per day

I think this is a VERY generous plan, considering what I see others having to do on their preop diet. Yes, it is for 4-6 weeks, however, considering the amount of protein I will be taking in, it will be easy to follow and will allow weight loss. The only complication will be getting bored with what I am eating/drinking. So I am trying to plan ahead (I took advantage of the sale on all 3 flavors of Premiere Protein from costco, I have placed an order for sample packs from Syntrax and powders?utm_source=BariatricPal&utm_medium=Affiliate&utm_campaign=CommentLink" target="_ad" data-id="1" >unjury, and I will be purchasing some items from the clinic of the New Direction items). I am noticing I am not a fan of items 'made' for protein - I loved the candy bar samples she gave me (and I don't care for sweets, ha), but when I tried the Soup, after a few bites, my stomach started to 'turn' and I had to stop eating it - I'm hoping that was a one time thing, or I might be in trouble!

After the nutritionist, I went straight to the financial counselor/wizard of the clinic - in other words, she takes care of everything. She gave me the intake patient packet which goes over all the steps and phases to surgery, all the clearances the doctor has ordered, all the tests I will need to have done, etc. At this point, I still had not asked all the questions I had written down, so I started asking her, figuring she would not be able to answer half, as most were medical. She had the answer to every single question. Even better, we had already been corresponding via email - so I have access to her via email - and she responds within a day, at most.

Finally, I went straight to do my labwork. They drew the blood, and I was done! They did tell me a nurse would probably be calling to tell me I had some Vitamin deficiencies somewhere, that everyone does - usually Vitamin D. That's 5 appointments, essentially, in one visit. They are EFFICIENT!

I have already been meeting with Active Health via my insurance company. They have a requirement of 6(7) months with them via telephone, or 3 months face-to-face with a doctor/nutritionist. Since I did not know how long it would take to get in to see a doctor, I was doing Active Health. Now that I'm in the clinic, I'm going to see the doctor. It should get me cleared approximately a month earlier. While not a big deal to most, there's a timing issue - end of the year (deductibles!) plus a family event in December I want to be 'healthy' for. So they set up that appointment before I left.

Let me just say - this appointment could not have gone better. For anyone who does not remember, I met with another doctor in April, and it was a horrible experience - the staff were rude, they argued about the diet (told me to eat salads, when I'm on blood thinners, and cannot consume much Vitamin K), and the doctor told me he would not do the surgery because of my medical history (I was dxed with Crohn's at 8, treated until 13, no treatment since then). I told him I had not been treated since 13, and that his website recommended the Sleeve for patients with Crohn's and Anemia, that's why I chose it. He said it did not. I showed it to him on my phone. He said, "I still won't do it." They also said I must lose 135 lbs before they would work with me, yet gave me no diet or any suggestions - even when I asked the doctor for suggestions, since I'm on the Depo shot and his nurse had just told me that made things more difficult, he just shrugged and said he didn't know. SO - I was a nervous wreck going into this appointment. I left the April appointment in tears - it had felt as though they never intended to work with me, and had no interest whatsoever in my care. This appointment, however - I could not have asked for better care or compassion!

All that to say - it was a great experience, and I am so thankful to finally be moving along on this journey! I hope this information will be helpful to someone out there!

Just to add on to what everyone else has said - the timing to have the surgery really does seem to be now.

As has been said - there will ALWAYS be obstacles and things that come up. As the old saying goes, if someone waits until 'the right time' or 'the right finances' to have children, there would never be any children born. The same applies here.

From another perspective - you said the children may likely be in the hospital for a bit, and one may have complications. So when would be a better time to have surgery - now, when they are in the hospital under close medical supervision, and only your moral support, not your physical attention is needed? Or later, when the children are home, and your daughter is trying to tend to them, and needs your physical help caring for two babies, one with possible medical needs? Seems to me like you should RUN to the hospital to get surgery ASAP!

Good luck to you, the new mommy, and the new littles!

Thanks for the info! I just ordered. So much cheaper than what I can find here - and easier than trying to track it down locally!

@@linzlou2000 - Thank you! I had a bad experience with a clinic back in April, but the clinic I'm working with now - well, I just can't say enough good things about. Now, I've only had one visit, but it was an excellent visit! LOL

I'm now looking at late October, possibly November. It all depends on insurance. I was doing the 6 (7) months with BCBS, but I started the 3 months with my doctors office. If insurance does not get touchy, I will finish the 3 months before the BCBS, and can submit and have surgery by end of October. If they are difficult because I was doing their program, as well, and make me wait (which I can't imagine why they would, if I have met the other optional criteria - we have a choice as to which one we want to do) - it would be end of October.

I'm in Mississippi, going to Baptist Nutrition and Bariatric Center

If so, I would definitely encourage anyone to go there. I had a bad experience at a different clinic back in the Spring. I went to this clinic last week - and honestly, it felt like heaven. They were EXCEPTIONAL! They were SO nice. They felt invested in my care from the moment I walked in the door. I walked in and was in the waiting room less than 10 minutes before I was called back, and they started working with me immediately. They did all kinds of work with me from the start. I have NO complaints, and could not ask for a better experience!

She is at Baptist Nutrition and Bariatric Center - it's at 1190 N. State Street

I have not had surgery yet, and I am very fortunate that my doctor does not require a liquid diet, only a change in diet - one I managed in the past (though doing it willingly and because I HAVE to are two different things).

That said - remember this isn't forever. You only have to do this for a few days. I would suggest setting yourself small goals. Make it through until noon without anything you're not suppose to have. Until four o'clock. Until 8 o'clock. Breaking up your times - then feel proud of yourself for every time frame you can make. You might even consider rewarding yourself! Put a dollar (or 5!) in a jar for every time frame you make it through for your new wardrobe you're going to need!

Since at night is when you're starting to graze/cheat (I have this same issue - I can be good all day, and then at night I lose motivation and want something to chew on!) - think of ways to combat that. Tape reminders up everywhere of what you're doing and why! On the fridge, cabinets, mirrors, etc., so you can NOT pretend it's not on your mind (I do it...I'll deliberately push it aside so I can eat something). Next, find something else to chew on that will give some satisfaction - ice (but don't over do it) - perhaps even get a mouth guard to chomp on. Whatever works! Another thing that works for me is...GO TO BED EARLY! If I go to bed and sleep... I forget I want to eat. So don't take any naps during the day, and get in the bed earlier at night.

Remember - this is only for a few days. Lose those last few pounds, take deep calming breaths to go to sleep, and before you know it, it will be surgery time. You WILL be able to do this, you can make it. Thousands of others here have - and you can be just as successful!!!

Good luck!

Mississippi. And I'm meeting with Dr. Cummings tomorrow!

I know how you feel which is why I've only told 3 people. Today when I went for my EKG the nurse asked if I've had this done before. I said no ma'am. She then asked if this was for some kind of pre op. I said yes ma'am for Dr asad. She then asked what surgery and there it was, "well youre not gonna do THAT are you?!? You're no bigger than me!" so the whole time she was asking me questions and giving me the stink eye and attitude. Lets just say I stopped calling her ma'am after five minutes of being there ????

And see, I would have wanted to say, "I know we are about the same size! Have you considered weight loss surgery?" Lol

Wednesday is the 'almost' big day! On Wednesday, I get to meet with my surgeon for the first time, the nutritionist, the bariatric nurse, the financial counselor, and do my lab work (I know, a lot at one time). I'm so excited!

Back in April, I met with a surgeon at a different clinic and it was NOT a good fit - it was a horrible experience, so I decided to choose a different clinic. I have been waiting on this appointment since the beginning of May. Since that time, rather than waiting and doing the 3 months of visits with the doctor/nutritionist required by insurance, I decided to be proactive, and have been doing the 6 months of phone visits with a nutritionist through my insurance company. I will complete these visits the first of October.

Since I have been doing this for a few months already, and waiting for a few months, even though I am just getting started with the clinic, it feels like I've been in the process for quite awhile already. I'm so anxious for my appointment on Wednesday I'm ready to burst! I wonder if they might need to sedate me just to make it through the first appointment? LOL

I get that you love your doctor. However, a doctor should support you, not attempt to control you with fear. If you are leaving your doctors office feeling bad about yourself and/or bullied, it's time to move on. And bullied is the word that is coming to me from reading your post.

A couple of years ago I went to a doctor who prescribed WL meds to give that a try. Every visit, all she did was harp on how horrible one of my other meds (Depo Provera shots) are, that I need to get off of them, how bad they are for me, etc. I tried to explain that I understood the risks, but my gynecologist, who I've been seeing for almost 10 years, had tried a half dozen other meds, and this one works... She didn't 'hear' me. She had her OWN AGENDA. And it did not coincide with mine. No Depo, at this time, means me coming close to bleeding to death (sorry if too much TMI) - it's the only thing stopping it. She didn't care, she just had this idea in HER head of what *I* should do.

So if your doctor 1) bullies and/or 2) has an agenda that does not mesh with yours and makes you feel unheard. Go elsewhere. I wanted to keep taking the meds... but I stopped, because I refused to go to a doctor who treated me with so little respect and had so little respect for me, my opinions, and my ability to make decisions.

I wish you the best of luck. Where there's a will, there's a way - even if it takes a little time!

My sleep study was done 11 years ago and my dr accepted it.

That's wonderful to know! I'm hoping since nothing really changes (unlike blood work, for example), mine will be accepted, as well!

Thank you for sharing!

I'm much earlier in my journey (I still have to meet my surgeon - but next week!). However, I've been compiling a list of questions. I'll share these, even though they are for folks a little earlier in the process, as it might help someone when prepping. Some, I know the answer to, others, were just things I was contemplating, but I'll add them all, just in case it might help someone...

Which surgery (sleeve or RNY?), based on current medical issues?

How long will I be in the hospital?

How long will I need to be off of work?

What tests/prep will I need before surgery (ie. other doctors)?

What Vitamins will I need to take post-op? Long-term/short-term?

What can I expect in regards to hair loss?

Is there a specific type of Protein product you require/prefer your patients to use?

What type of pre-op diet do you require?

What type of post-op diet can I expect?

(by the way - I have on my list, as well, about the catheter, drainage tube, etc., lol)

My surgery is Saturday! I'm so excited!

Yay! Congrats! I can't imagine how excited you must be! In no time at all, you'll be living a new life!! Please let us know how it goes!

Mistie:

It sounds like your surgeon is like mine. Mine requires all of the age-appropriate testing be done prior to surgery. Since I was 50 when I started the process, and hadn't had a colonoscopy, I had to have one. Pap smear had to be within 2 years (I think). Mammogram had to be within a certain numbers of years. All of these timeframes were the accepted standard of care in place at the time.

Since I have a history of PVCs (premature ventricular contractions) caused by sleep apnea, I had to have a cardiac stress test for cardiac clearance.

I use a v-pap (variable pressure) now so I didn't have to have any sleep testing. He only required it if you had not had the test.

My insurance required a psych eval and 6 months of nutrition visits (although they dropped that requirement on 7/1/15), along with a BMI of a certain amount.

All of the other things were requirements of my surgeon. I had an upper GI to check for a hernia. I had an upper endoscopy during my colonoscopy. Today at my preop I had an EKG, a chest xray, and blood work.

Don't laugh - it's not that my doctor has required anything (yet), I'm just trying to prepare before my FIRST visit! LOL. These are just some of the tests I've heard (read about) others have had to have, so I was just wondering if more recent tests I've had done would 'count,' to save time, money, and quite frankly, the experience of doing them again! I hate the colonoscopy (I can't be put to sleep with narcotics, I stop breathing - so I have to be awake during this procedure...FUN!) and sleep study. Everything else, I don't mind.

If I can bypass the sleep study and colonoscopy, potentially pulmonary, as I saw him last year (I have a history of pulmonary emboli), I anticipate the EGD, EKG, and quite likely a visit to the cardiologist (no heart problems REALLY, but I had several mild heart attacks a few years ago due to a random virus - the receptors on the virus were the same as on my heart, so when fighting off the virus, my body attacked my own heart! The damage healed up quickly though, since it was an external cause) - none of these do I mind though, as they are fairly quick and painless.

Now, my mother DID ask if I thought, when they tell me to go do the psych eval, if they would just let me talk to myself, since I'm a licensed counselor (actually, PhD, rofl). Hmmm, now wouldn't that be an awesome report!

Glad you've gotten so much of yours out of the way, @@Sharon1964 - you must be getting close!

Mistie So sorry to hear you have been postphoned till next week. Wow you certainly are meeting with a lot of people.During my first visit I only met the surgeon and the nurse who took my weight and went over all my meds that I take. About a week later I met the NUT and do not need to see her again. Hope all goes well for you when you do meet them all next week.

Thank you! I look at it as I just have time to come up with more questions. I am also going to go ahead and get medical records from some of the doctors I know they will want them from (ie. gastro doc, obgyn, etc.), as I do have a complicated medical history. And I know! They told me to expect to be there several hours. Honestly, I think it's great. It's a 3 hour drive, so I'll take care of a lot at one time. It also helps me feel that things are/will be moving right along, AND this will allow me to get so many questions answered, because I will be meeting with almost everyone in one day! It also makes it feel like they are more efficient, and I like that. I went to another doctor previously, and it was a disaster (they told me I had to lose 125 lbs before they would do surgery - uh...that's why I'm here? They also never set me up for a nutritionist, instead, tried to tell me to eat salads to lose 125 lbs before I could have surgery - when I reminded them I could not, because of taking Coumadin, the nurse was clueless - talk about flashing red lights going off! - and then the doctor said he would not operate on someone with a history of Crohn's disease - even though I have not been treated since I was 13, ie. 26 years ago, and it says on his website which surgery is recommended for someone with Crohn's!), so I chose not to return to that clinic, and instead, chose this clinic courtesy of my PCP. So they are definitely getting points for arranging everything like this! After the last attempt... I'm definitely praying for a better outcome. I admit to being quite nervous - not about the surgery or anything else, more so because of my experience with the other doctor!

That's for the feedback, guys! You're giving me hope! One less thing to stress over (I would rather not stress, and then be told I have to do it, than to simply stress all that time, and have to do it anyway - at least I'll get a little peace until I know for sure, because there's hope! LOL).

I was suppose to meet with my surgeon for the first time tomorrow (surgeon, bariatric nurse, do labs, meet with financial person, and nutritionist - all at the first appointment, whew!) - however, the surgeon had something come up and won't be there. They moved me to next week. Glad it wasn't longer, since it took me almost 2 months of waiting just to get in now!

Exactly what I went through! But even worse I didn't get to the bathroom in time and peed my pants. Had to cut the underwear off and hope and pray the sheet cover didn't come off during the rest of the night. I told my Surgeon I had that test done years ago. Had a Cpap machine, got a terrible sore throat twice and finally gave the machine back to the rental company as I couldn't stand it. He said so nothing has changed and I said nope. So I assumed I don't have to take the test again. Have 4 more supervised visits and will have to ask him for sure.

Oh my goodness! That's terrible. To me, that skews the results somewhat...when you can't actually sleep for the sleep study! I'm thinking, like you, what's changed? Pretty much, once you have it, you have it, until you start losing the weight...soooo! I'm crossing my fingers (and if I ever have to do another sleep study, my legs, too!)

sleep test = disguised torture!

"Here, let's hook several dozen electrodes to your body; attaching them with a nasty goo in your hair all the way to your feet. Then, we are going to tell you to go into a room where WE control the temperature, and tell you to lie on a bed that may or may not be made of concrete. We will leave some lights on so we can look at you all night - yes, we know it's creepy. Now, wiggle onto the bed withOUT knocking off an electrode. Wait, you have to pee? Sigh. Ok. Don't let any of your hanging wires dip into the toilet! Back? Great! Let's try again. Now, all this... Now we want you to....GO TO SLEEP! We won't disturb you unless an electrode comes off or malfunctions - which is approximately every time you manage to doze off. sleep tight!"

Yeah, I hate that test too! Roflmao. Guess it isn't so bad for most, but I'm such an uneasy sleeper, I was just miserable! I might beg my surgeon for mercy! Hah

I'm not sure @@Elode, I just saw several mention the colonoscopy, and I hate that one - so crossing my fingers I can bypass it since the tests are every 5 years and I'm only 2 out. Same with sleep, hate the test, and hoping since already dxed, they would just say ok. It's not like the sleep disorders went away! Lol

Thanks for the feedback!

Hi folks,

Just a question. I know every doctor will be different, but does anyone have experience with a doctor allowing/not allowing tests previously conducted to be utilized?

I ask because I have had sleep studies done twice in the past (most recent in 2010) and my most recent colonoscopy was in 2013. I know my doctor will tell me, just curious 'beforehand' about the experience of others.

Thanks!

@@jss1988 - it's a great option! The other was the 3 months supervised, but since I wasn't with the surgeon yet, thought this was faster. Even more interesting, is since I just completed month 3, they are sending me a gift pack, has a pedometer, resistance bands for arm exercises, a cookbook, and a few other goodies. So glad BCBS finally approved wls!

I'm hoping for November or December. I met with one doctor who was a jerk, so I am now scheduled elsewhere. To save time, I chose the 6 month phone calls with ActiveHealth (through insurance). I am scheduled for a visit with the surgeon for August 5. I'm hoping to accomplish all other requirements between then and the first of November when I finish the phone calls. Then I submit for approval and get a date. So, as long as the docs schedule works with me, I can do November/December.

First, I want to thank everyone for your replies and support. It means SO much to me. I am generally not a weepy person - as a professor and counselor I've learned to keep pretty tight control of my emotions. Yesterday, however, I was crying at the drop of a hat! All day long. Even until I went to bed. Every time I would get a new response here in my email, I started all over again. What most people would not understand (except you guys!) is that the appointment itself was shocking and a disappointment, and I left feeling defeated - in ways I never would have imagined. I really felt like I got shafted yesterday. Not only with what I expressed earlier regarding the weight loss and Crohn's, but I went in expecting to be setup to see the nutritionist to start the supervised weight loss (ie. as required by insurance), to talk with someone about insurance and how much the total would be, etc. Instead, he seemed to just be going through the motions without any real plans to see me - just shuffled me out the door.

To respond to everyone's questions/comments.

The center IS one of the Center's of Excellence. My insurance company requires it - so they do have the full team of nutritionists, psychologists, etc. My insurance requires three months of supervision by one of the centers, as well. The doctor did not require the weight loss specific of me - the nurses told me before I ever saw him - he requires everyone to have a BMI below 55 before he will operate. The diet they gave me - their pre-op diet, IS a low-carb/high-Protein diet - unfortunately, many of the foods they are telling me to eat on it are foods I cannot eat due to my blood, for example. As for the surgery - I told them I was interested in the Sleeve. Although it is irreversible, which makes me more nervous, I did my research. Research says that it is better for patients with a higher weight, it is better for patients with Crohn's and Anemia (due to absorption issues, I am guessing), etc. Although some of the stats say RNY has a higher overall weight loss, the sleeve seemed a better option due to my own health issues - which I took into consideration before ever meeting with the doctor.

In regards to the green stuff + blood thinners: It's not the blood thinners with which the green stuff is incompatible with, it's blood in general. Whenever you have blood clotting issues, you are suppose to eat a VERY limited amount of green, leafy items. Ie. cabbage, lettuce, broccoli, etc. Last year, they said that included other 'green' veggies, as well, as I was eating a lot of asparagus (it was my go-to veggie when losing weight) - it was messing up my blood. The 'green stuff' thickens your blood, in the same way alcohol thins it (it's the reason you are not suppose to take aspirin for a hangover - they both thin your blood). I mean, I guess I COULD eat a salad and then drink some alcohol, but that might be defeating the purpose

As far as what I do now - I cut out salt years ago. If I DO ever drink soda, it's diet - I drink Water almost exclusively. I eat minimal carbs - I am simply not a bread, rice, Pasta type person. I use a Fitbit and walk a set number per day. I have been using LoseIt! for a couple of years and log every bite of food I eat and every minute of exercise I do. I go to Water aerobics several times a week. So, in a lot of ways, I feel that I was somewhat ahead of the game in preparing.

I acknowledge I've had a lot of health problems. Oddly, none of them are weight related! I have perfect BP, low cholesterol, etc. I would like to KEEP it that way!

I have already called a clinic I went to several years ago which said they did NOT see any signs of the Crohn's. I have asked for my records. This can be 'proof' for him, with or without additional testing. As well, I have looked at another center. As I said, there are three in my state. He's about an hour away. The second I have seen mixed reviews. The third is about three hours away, but my general MD likes it. I looked on their website, and they require a weight below 400 lbs. That I can manage.

I THINK I got everyone's questions...!

Again, I appreciate all of the support. I have never opened up about my weight to anyone, and although I have a beyond supportive family, they simply do not understand. My mom keeps saying she has struggled with weight all of her life, and this is true, but not to the same extent.

To everyone on here - keep doing what you do for everyone else on here. Your words of encouragement, no matter how strong the support system of others, are so much more meaningful than you can ever know...